Infection Presentations In The Returning Traveller Flashcards
1
Q
What are the most common causes of travellers diarrhoea?
A
- enterotoxigenic E. coli
- enteroaggregative E. coli
2
Q
What is the management of travellers diarrhoea
A
- usually self-limiting
- fluid replacement
- antibiotics (only if indicated - remember viral illness)
- quinolones, azithromycin ?
- antimotility agents
- investigations for other causes
3
Q
What causes schistosomiasis?
A
- helminth (trematode - flatworm)
- S. haematobium
- S. mansoni
- S. japonicum
4
Q
What increases the risk of schistosomiasis?
A
- freshwater (NOT saltwater)
- swimming
- paddling
- drinking
- showering
5
Q
Describe the pathogenesis of schistosomiasis
A
- cercariae containing infection penetrate skin in fresh water
- cercarie lose tails to become schistosomulae and enter circulation
- migrate to portal blood in liver and mature into adults
- paired worms can migrate to mesenteric venules of bowel/rectum (where they can lay eggs that can circulate to liver + be shed in stools), and the venous plexus of bladder
6
Q
What are the symptoms of schistosomiasis infection?
A
- usually asymptomatic (esp in residents of endemic areas)
- swimmers itch soon after infection
- katayama fever at least 6 weeks after infection
7
Q
How to reduce risk of schistosomaisis infection?
A
- brisk towelling after water contact
- deet bug repellent before water contact
- waterproof sun cream
8
Q
Describe the diagnosis of schistosomiasis
A
- dependent on presence of eggs (takes 6 weeks)
- serology = antibodies to egg antigen
- urine/stool sample
9
Q
What is the treatment of schistosomiasis?
A
- praziquantel 40mg/kg on one day
